Did New Liver Transplant Guidelines Reinforce Inequality?

In 2020, new Organ Procurement and Transplantation Network guidelines went into effect regarding liver transplants. At the time, the organization noted that the revamped guidelines “[replaced] Donation Service Areas and regions with a series of circles for distributing livers.” The goal? To “help liver transplant candidates throughout the country.” The new guidelines allowed for livers to be transported to higher-risk patients within a radius of 500 nautical miles under certain circumstances.

It’s an understandable goal — getting organs to the neediest people who would be in danger of dying without an immediate transplant. But according to a new Washington Post investigation, conducted in conjunction with the Markup, the new guidelines may have opened the door to some new issues along the way.

As Malena Carollo and Ben Tanen write at the Post, an analysis of data suggests that the new guidelines have resulted in more patients in wealthy states getting transplants, even as poorer patients are passed over. Carollo and Tanen point to an increasing number of transplants in New York and California since the new policy went into effect — and a decline in a number of states, along with Puerto Rico.

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This unusual transplant can revive tissues, including the heart and brain.

The whole article is well worth checking out, and the authors also note that California and New York weren’t the only states experiencing a relative increase in liver transplants — including Oklahoma and Utah. But it points to a measure taken to address one issue that may have caused more issues than it solved — and could require further adjustment in the near future.